ESIR 2025: Portovenous interventions with Prof. Minko

February 24, 2025

The European School of Interventional Radiology course on portovenous interventions of the liver will take place in Düsseldorf from April 24-25.

Local host Prof. Peter Minko spoke to us about his clinical work and what attendees can expect from April’s course on portovenous interventions.

CIRSE: What inspired you to develop the upcoming course on portovenous interventions of the liver?  

Minko: Portovenous interventions comprise a variety of complex interventions. There is a lot to learn from both a practical and theoretical point of view, which is what makes this topic so interesting. I am happy and thankful to have a great faculty on hand, we’re going to be able to learn from each other and share practical tips and tricks. Portovenous interventions are underrepresented in our daily clinical practice, especially in children. This is a realm in which we as IRs can strengthen our position, show what we can do, and make a difference for our patients. Since we had a successful course in 2023 which was met with high demand from participants, it was logical to set up a new course and dive deeper into different aspects of this topic.

Prof. Minko presenting at ET last year.

Participants after the previous ESIR course on portovenous interventions

Participants practice techniques during a previous ESIR course on portovenous interventions.

CIRSE: What key topics will participants get to delve into during this comprehensive course?

Minko: I am especially looking forward to diving deep into the complexities and differences between performing TIPS in adults and children – this course dedicates a whole day to the topic. We are going to cover differences in indications, patient management, the procedure, and aftercare. Furthermore, we are going to discuss alternatives to TIPS, like BRTO or PARTO, and will focus on the differences in outcomes. On the second day, we are going to focus on the topic of portal vein embolization. We will discuss how to perform it, hear some experiences from surgeons, and discuss the different results. Finally, we are going to concentrate on the treatment of portal vein thrombosis, including indications, management, and treatment strategies.

CIRSE: You are a well-known expert in portovenous procedures such as TIPS/PVE – can you describe what your current practice looks like?

Minko: Alongside other interventions, my current practice includes the broad spectrum of TIPS, portal vein embolization, and the treatment of portal vein thrombosis. TIPS has become a routine intervention at my centre, we do more than 100 TIPS procedures per year. We work very closely with our colleagues from the gastroenterology department. TIPS interventions in children are rare. Portal vein embolization is also a frequent intervention here in Düsseldorf because we have great liver surgeons here and work in a close interdisciplinary team. This is also true for portal vein thrombosis, in which we can use our full arsenal of IR materials.

CIRSE: How do you incorporate a multidisciplinary approach in your practice?

Minko: Here in Düsseldorf, TIPS procedures are done together with our gastroenterology colleagues, both of us are at the table. This really helps incorporate us as a multidisciplinary team, and we are used to working closely together. This results in deeper clinical understanding and practice, and we can discuss and treat complex cases together. The resulting clinical education our colleagues receive means that they will keep bringing IRs to the table. Furthermore, this results in better education for fellows and students and has a positive impact on our scientific work as well. I think this is a win-win situation for everybody.

CIRSE: What are your observations on how portovenous interventions, including TIPS and portal vein embolization therapy, have evolved in recent years?

Minko: I think that portovenous interventions have gained more and more attention and have become essential in modern clinical practice. Our clinical partners have the need, and we have the knowledge and tools to perform this procedure. The technology and tools we have used since the invention of these procedures have developed over time, and the fast advancements in technologies and different tools now available make these often-difficult procedures more acceptable and accessible to a broader range of IRs.

CIRSE: What distinguishes this iteration of the course from previous ones?

Minko: This year, we will focus on TIPS procedures in adults and show the differences between TIPS procedures in adults and children. We will also integrate deep dive sessions in small groups, so that participants will have the opportunity to gain knowledge and discuss several topics in detail with experts. We will do the same on the topic of portal vein thrombosis and portal vein embolization, giving participants the whole spectrum of portal vein interventions.

CIRSE: Why should interventional radiologists make the trip to Düsseldorf for this course?

Minko: Düsseldorf is a great city to visit. Architecture, culture, fashion, and food are highlights of this city. Here you can feel the pulse of a city but also have nature right in front of you. The largest Japanese community outside of Japan is here in Düsseldorf, giving the city a multicultural experience for visitors.

CIRSE: Has being an ESIR local host impacted your career?

Minko: My clinical and personal career, yes. Being a host gives you the opportunity to learn a lot. Not only is the organization and management of the course interesting, being able to learn from participants and faculty members from all over the world is priceless.